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Vermont rates for HCPCS 0264T

Intramuscular autologous bone marrow cell therapy, with preparation of harvested cells, multiple injections, one leg, including ultrasound guidance, if performed; complete procedure excluding bone marrow harvest

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.00 / $84.00 / $84.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,249.75 / $3,249.75 / $3,249.75
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,249.75 / $3,249.75 / $3,249.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.91 / $219.59 / $716.67